Depressed men with a diagnosis of intermediate- or high-risk prostate cancer (PCa) have worse overall outcomes, according to a study published online ahead of print in the Journal of Clinical Oncology.
Sandip M. Prasad, MD, from the Medical University of South Carolina in Charleston, and colleagues reviewed Surveillance, Epidemiology, and End Results-Medicare linked data. Of the 41,275 men diagnosed with clinically localized PCa from 2004 to 2007, 1,894 men were identified with a depressive disorder in the 2 years before the PCa diagnosis.
Men with depressive disorder were significantly older, significantly more likely to be white or Hispanic, unmarried, reside in non-metropolitan areas and areas of lower median income, and had significantly more comorbidities. Men with depressive disorder were significantly more likely to undergo expectant management for low-, intermediate-, and high-risk disease, in adjusted analyses.
Depressed men were significantly less likely to undergo definitive therapy (surgery or radiation) across all risk strata. Depressed men with low-, intermediate-, and high-risk disease were 86%, 25%, and 16% more likely to die than non-depressed men.
“In summary, these results point toward a newly identified disparity in the management of men with incident prostate cancer,” the authors wrote. “Men diagnosed with depression and intermediate- or high-risk prostate cancer are less likely to undergo definitive therapy.”